Abstract | What is already known about this topic?: What is added by this report?: In this study, we encountered a unique case of community-acquired NDM-5 Escherichia coli urinary tract infection (UTI) following coronavirus disease 2019 (COVID-19). The UTI persisted for a duration of at least 45 days. Genomic analyses revealed the presence of two NDM-5 strains, both sharing an identical chromosomal background but distinct, homologous, and recombined plasmids. This case suggests that a diverse range of resistance genes may be present within the human body, with drug-resistant strains undergoing continuous evolution during infection. The intestinal tract may have been its drug-resistant gene pool. What are the implications for public health practice?: The observations presented in this case indicate that the endogenous acquisition of drug-resistant genes may also be an issue in managing multidrug-resistant organisms (MDRO). It is possible for continuous recombination to occur within carbapenem-resistant Enterobacteriaceae (CRE) during infection. In contrast to exogenously-acquired resistance, greater attention should be placed on the endogenous factors that contribute to the development of CRE within healthcare settings.
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Authors | Jiazhen Guo, Ran Duan, Dan Zhang, Peng Zhang, Shuai Qin, Yajuan Fang, Yingna Sun, Lianhe Lu, Huaiqi Jing, Xin Wang, Rongmeng Jiang, Biao Kan |
Journal | China CDC weekly
(China CDC Wkly)
Vol. 5
Issue 26
Pg. 565-571
(Jun 30 2023)
ISSN: 2096-7071 [Electronic] China |
PMID | 37457852
(Publication Type: Journal Article)
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Copyright | Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2023. |